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Intersphincteric Resection versus Stapled Coloanal Anastomosis for Low Rectal Cancer
Journal of the Korean Society of Coloproctology ; : 113-120, 2008.
Artigo em Inglês | WPRIM | ID: wpr-104437
ABSTRACT

PURPOSE:

Local control and functional results of an intersphincteric resection are controversial in Asian, low BMI patients, even though it might a provide a chance to avoid a permanent colostomy. We tried to evaluate the potential risk of an intersphincteric resection, compared with a stapled coloanal anastomosis, in patients with low rectal cancer.

METHODS:

Patients with low rectal cancer, who underwent a intersphincteric resection with a hand-sewn anastomosis (ISR) or a coloanal anstomosis with staples (stapled CAA), were analyzed.

RESULTS:

From 1999 to 2006, 85 patients were enrolled. The distance between the anal verge and the lower margin of the tumor was 3.4+/-0.8 cm (range 2~5 cm) in the ISR group and 4.9+/-0.8 cm (range 3~7 cm) in the stapled CAA. The mean body mass index was 23 (range 18~32). The patients complained postoperatively of intolerable anal incontinence (Kirwan's class > 2) in 35% of the ISR group and in 9% as the stapled CAA group, (P<0.02). The local recurrence rate was greater in the ISR group (15%) than in the stapled CAA group (2%, P<0.04). There was no significant difference in distant metastasis between the two groups. The disease-free survival rates were 80.8% and 91.2% at three years in the ISR group and the stapled CAA group, respectively. Complications, such as urinary incontinence and sexual dysfunction in male patients, were not significantly different between the two groups.

CONCLUSIONS:

An intersphincteric resection with hand-sewn anastomosis could be worse than a stapled coloanal anastomosis in function and local recurrence. This may indicate that careful selection is required for a intersphincteric resection even when a stapled anastomosis cannot be applied due to a narrow margin.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Retais / Recidiva / Anormalidades Congênitas / Incontinência Urinária / Colostomia / Índice de Massa Corporal / Intervalo Livre de Doença / Povo Asiático / Orelha / Metástase Neoplásica Limite: Humanos / Masculino Idioma: Inglês Revista: Journal of the Korean Society of Coloproctology Ano de publicação: 2008 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Retais / Recidiva / Anormalidades Congênitas / Incontinência Urinária / Colostomia / Índice de Massa Corporal / Intervalo Livre de Doença / Povo Asiático / Orelha / Metástase Neoplásica Limite: Humanos / Masculino Idioma: Inglês Revista: Journal of the Korean Society of Coloproctology Ano de publicação: 2008 Tipo de documento: Artigo